scholarly journals Calcifying pseudoneoplasm of the neuraxis (CAPNON) associated with neurenteric cyst: an autopsy case showing unusual fatal outcome

2021 ◽  
Author(s):  
Shojiro Ichimata ◽  
Yukiko Hata ◽  
Akane Aikawa ◽  
Shin Ishizawa ◽  
Daisuke Sato ◽  
...  
Keyword(s):  
Fatal Outcome ◽  
Treatment Strategies ◽  
Mass Effect ◽  
Neurenteric Cyst ◽  
Case Presentation ◽  
Tonic Seizure ◽  
Emergency Transport ◽  
History Of ◽  
Delay Of Treatment ◽  
The Masses

Abstract Background Calcifying pseudoneoplasm of the neuraxis (CAPNON) is a rare calcified tumefactive lesion that can occur in the brain or spine. Although the aetiology and natural course of CAPNON has not yet been fully established, recent study reported that many CAPNON cases have dual pathology, which may be associated with its aetiology. Case presentation A 53-year-old man with a history of an untreated brain mass was taken to a hospital by emergency transport. A computed tomography scan revealed an intracranial hypo-attenuated mass exhibiting mass effect. Several calcified foci were observed around the lesion. He suddenly showed tonic seizure after admission, therefore an emergency craniotomy was performed. However, he unfortunately died due to advanced cerebral oedema. Microscopic findings of the surgically obtained materials were consistent with neurenteric cyst (NC). Intracranial hard masses were found adjacent to NCs and the masses were composed of fibrous cartilage-like matrix with massive linear calcification and surrounding round-to-oval epithelioid cells. Conclusion CAPNON associated with NC was considered to be most appropriate diagnosis of present case. To the best of our knowledge, this is the first report of such case. The present case suggests that delay of treatment may cause a poor outcome, at least in CAPNON associated with NC. Careful investigation, including of the underlying pathology, may be essential for deciding treatment strategies for CAPNON.

scholarly journals Microvascular Decompression for Patient With Coexistent of Trigeminal Neuralgia, Hemifacial Spasm and Glossopharyngeal Neuralgia- a Case Report

2021 ◽  
Author(s):  
Tao Sun ◽  
Wentao Wang ◽  
Longshuang He ◽  
Yu Su ◽  
Ning Li ◽  
...  
Keyword(s):  
Nervous System ◽  
Trigeminal Neuralgia ◽  
Hemifacial Spasm ◽  
Treatment Strategies ◽  
Glossopharyngeal Neuralgia ◽  
Case Presentation ◽  
Involuntary Contraction ◽  
History Of ◽  
Primary Trigeminal Neuralgia

Abstract Background: Primary trigeminal neuralgia (TN), hemifacial spasm (HFS) and glossopharyngeal neuralgia (GN) are common diseases of nervous system, with similar pathogenesis and treatment strategies. Coexistent of such disease, especially coexistent of TN-HFS-GN simultaneously, is very rare. To date, only nine cases have been reported.Case Presentation: A 70-year-old male with a history of hypertension and diabetes complained of severe involuntary contraction for about 10 years, knife-like and lighting-like pain, which was restricted to the distribution of the second and third branches of trigeminal nerve and pharynx and root of tongue, for about 2 years. Coexistent of TN HFS and GN was diagnosed and MVD was carried out. After MVD, the patient completely free from symptoms and no recurrence and hypoesthesia were recorded in 18 months follow up.Conclusion: Here we report the tenth and oldest male patient with coexistent of TN-HFS-GN. Despite limited reports, MVD is the preferred choice for such diseases which can free patients from spasm and neuralgia.

scholarly journals Endogenous Heparin-Like Substances May Cause Coagulopathy in a Patient with Severe Postpartum Hemorrhage

2019 ◽  
Vol 47 (4) ◽  
pp. 337-343
Author(s):  
Shichun Wang ◽  
Chao Qi ◽  
Zhicheng Liu ◽  
Ting Xu ◽  
Chunyan Yao
Keyword(s):  
Reaction Time ◽  
Postpartum Hemorrhage ◽  
Treatment Strategies ◽  
Coagulation Factors ◽  
Coagulation Disorder ◽  
Case Presentation ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
Heparin Activity ◽  
Spontaneous Delivery

Introduction: Postpartum hemorrhage (PPH) is associated with maternal morbidity and mortality. Accurate diagnosis of the cause of puerperal hemorrhage is as important as treatment strategies for resuscitation. We report a case of coagulation disorder caused by endogenous heparin-like substances in a PPH patient. Case Presentation: A 30-year-old woman with no medical history of bleeding disorders suffered intractable hemorrhage following spontaneous delivery in a local hospital. The patient was transferred to the department of obstetrics of a superior hospital. On arrival, the patient was found to have severe hemorrhagic anemia, hemorrhagic shock, and disseminated intravascular coagulation. Active treatments were performed, but the patient continued bleeding. Laboratory testing, performed during early treatment, revealed that all coagulation factors were below normal. The differences between CK-TEG R-time (reaction time in citrated kaolin thromboelastography assay) and CKH-TEG R-time (reaction time in citrated kaolin with heparinase thromboelastography assay) suggested the presence of heparin activity. However, the patient’s family denied heparin use prior to presentation. Thus, we deduced that endogenous heparin-like substances were the main cause of the coagulopathy. After receiving treatment with protamine, the patient stopped bleeding. Meanwhile, all coagulation parameters and the TEG assay results improved. Conclusions: In this case report, TEG assay suggested the presence of heparin activity in a PPH patient, and treatment also highlighted the importance of analyzing different parameters in TEG.

scholarly journals Extensive Upper Airway Hematoma Secondary to Supratherapeutic Warfarin Anticoagulation

2020 ◽  
Vol 4 (4) ◽  
pp. 634-635
Author(s):  
Taofiq Oyedokun ◽  
Kevin Durr
Keyword(s):  
Upper Airway ◽  
Mass Effect ◽  
Endoscopic Examination ◽  
Past Medical History ◽  
Fatal Complication ◽  
Case Presentation ◽  
History Of ◽  
Retropharyngeal Hematoma ◽  
Significant Mass Effect ◽  
Significant Mass

Case Presentation: A 63-year-old female presented to the emergency department complaining of cough, neck swelling, dysphagia, and dysphonia for two days, with a past medical history of atrial fibrillation managed with warfarin. Investigations revealed a supratherapeutic international normalised ratio (greater than 10). Imaging and endoscopic examination showed an extensive retropharyngeal hematoma with significant mass effect on the airway. Discussion: A rare but potentially fatal complication of warfarin anticoagulation is upper airway hematoma, with violent coughing described as an inciting cause. Signs of airway compromise necessitate specialist consultation and definitive airway management, while mild cases without airway concerns can be managed conservatively with medical anticoagulation reversal.

scholarly journals Struma ovarii and peritoneal strumosis during pregnancy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zheng Li ◽  
Jingxue Wang ◽  
Qian Chen
Keyword(s):  
Caesarean Section ◽  
Clinical Presentation ◽  
Complete Resection ◽  
Struma Ovarii ◽  
Thyroid Follicle ◽  
Case Presentation ◽  
Pelvic Masses ◽  
History Of ◽  
The Masses ◽  
Ovarian Dermoid Cyst

Abstract Background Struma ovarii is a special type of ovarian dermoid cyst and accounts for approximately 2–3 % of all dermoid tumours. Benign struma ovarii may manifest as distant metastasis, called peritoneal strumosis, which makes it biologically similar to malignancy, and has been reported in limited cases but never discovered during pregnancy. Case presentation We report a patient with a history of right struma ovarii cystectomy. During pregnancy, pelvic masses with non-specific clinical presentation were found again. During the caesarean section, contralateral struma ovarii with dissemination of nodules in the peritoneal cavity was found, and pathology revealed that the masses were thyroid follicle ovarian goitres. Discussion and conclusions Recurrent benign struma ovarii with extraovarian dissemination is a rare aggressive clinical manifestation different from malignancy. It is emphasized that adequate assessment and complete resection of suspicious masses are of great importance.

scholarly journals Appearance of isolated thrombocytopenia in a patient of acute subdural hematoma

2015 ◽  
Vol 22 (1) ◽  
pp. 101-103
Author(s):  
S. Satish Kumar ◽  
M. Srinivas ◽  
K. Raghu ◽  
P. Shashidhar ◽  
Amit Agrawal
Keyword(s):  
Critically Ill ◽  
Subdural Hematoma ◽  
Critically Ill Patients ◽  
Clinical Status ◽  
Fatal Outcome ◽  
Mass Effect ◽  
Sudden Onset ◽  
Acute Subdural Hematoma ◽  
Underlying Illness ◽  
History Of

Abstract Thrombocytopenia in critically ill patients probably reflects the severity of the underlying illness and these patients have a higher mortality due to the severity of overall clinical status. In present article we report a case of acute subdural hematoma who developed progressive thrombocytopenia resulting in fatal outcome. A 75 year gentleman presented with history of sudden onset headache and lapsed into altered sensorium. There was history of trivial fall before he developed headache. The patient was deeply comatose with pupils bilateral 2 mm and reacting to light. Computerized tomography (CT) scan brain showed large right fronto-temporo-parietal acute subdural hematoma with mass effect and midline shift. Post-operatively he was kept on elective ventilation. On following days the patient continues to develop thrombocytopenia (Day- 3 Platelet count 75,000, day-4 60,000, day-5 25,000). Thrombocytopenia is a common but a potentially life-threatening condition problem and has been considered to play a role in worsening the prognosis of critically ill patients in intensive care unit. Few studies statistically examine the strength of the association between risk factors and outcomes related to thrombocytopenia, additional research is recommended to identify putative molecular determinants.

scholarly journals The Giant Parathyroid Adenoma: The largest ever reported

2021 ◽  
Author(s):  
Rahim Mahmodlou ◽  
Amin Sedokani ◽  
Apameh Pezeshk ◽  
Bita Najafinejad
Keyword(s):  
Back Pain ◽  
Parathyroid Hormone ◽  
Parathyroid Adenoma ◽  
Neck Mass ◽  
Case Presentation ◽  
Lower Back ◽  
Thyroid Mass ◽  
Parathyroid Adenomas ◽  
History Of ◽  
The Masses

Abstract BackgroundGiant parathyroid adenoma is defined as weight >3.5gr and size of more than 2cm.Case PresentationThis report describes the largest primary parathyroid adenoma according to the literature. The case is a 48-year-old man referred to the clinic with knee and lower back pain. He had a history of mitral valve replacement and several episodes of bilateral nephrolithiasis. After a thorough assessment, a neck mass with a possible thyroid origin was detected but further assessment showed it was of parathyroid origin. The resected mass was 9×6×4cm and weighed 122gr, and histopathology showed a giant parathyroid adenoma.ConclusionGiant parathyroid adenomas which weigh more than 110gr and are larger than 8cm can lead to significant hypercalcemia. Despite the size of the giant parathyroid adenomas and high parathyroid hormone levels, a calcium crisis may not always occur in these patients and the masses may be initially misdiagnosed as a thyroid mass.

Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 155-160
Author(s):  
Mohsen Aghapoor ◽  
◽  
Babak Alijani Alijani ◽  
Mahsa Pakseresht-Mogharab ◽  
◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
The Body ◽  
Lower Limbs ◽  
Lumbar Pain ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Death Case ◽  
Therapeutic Results ◽  
History Of ◽  
Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

Adenoid Cystic Carcinoma of Lacrimal Gland

JMS SKIMS ◽  
2012 ◽  
Vol 15 (1) ◽  
pp. 76-77
Author(s):  
Mohd Athar ◽  
K S Sodhi ◽  
S Kala ◽  
R K Maurya ◽  
S Chauhan ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Natural History ◽  
Adenoid Cystic Carcinoma ◽  
Salivary Glands ◽  
Hard Palate ◽  
Clinical Course ◽  
Fatal Outcome ◽  
Minor Salivary Glands ◽  
Adenoid Cystic ◽  
History Of

Adenoid cystic carcinoma is a relatively uncommon tumour of salivary, glands and is characterised by a prolonged clinical course and a fatal outcome. It was first described as `cylindroma' by Billroth in 1859. Half of these tumors occur in glandular tissues other than the major salivary glands; principally in the hard palate, but they can also arise in the tongue and minor salivary glands. Unusual locations include the external auditory canal, nasopharynx, lacrimal glands, breast, vulva, esophagus, cervix and Cowper glands. The long natural history of this tumor and its tendency for local recurrence are well known. JMS 2012;15(1):76-77.

An Obscure Colon Dilatation and its Underlying Cause: Case Report and Literature Review

2020 ◽  
pp. 1-5
Author(s):  
Anton Stift ◽  
Kerstin Wimmer ◽  
Felix Harpain ◽  
Katharina Wöran ◽  
Thomas Mang ◽  
...  
Keyword(s):  
Case Report ◽  
Sigmoid Colon ◽  
Immunohistochemical Staining ◽  
Late Onset ◽  
Hirschsprung Disease ◽  
Endoscopic Examination ◽  
Case Presentation ◽  
Idiopathic Megacolon ◽  
History Of ◽  
Cells Of Cajal

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.

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